We explored fatigue - a common symptom of long Covid. To do this, we conducted a systematic review of the literature and explored the lived experiences of those who are managing or have overcome fatigue

Many people with Post Covid Syndrome (also known as Long Covid) describe symptoms of fatigue.  Different ways of treating fatigue are used for post-viral infections or illness such as ME/fibromyalgia. We wanted to explore the research evidence-base for interventions that are used for treating fatigue; to investigate what might be effective in the support and treatment for people with Long Covid.

To do this, we are completing a systematic literature review. This is a search and analysis of the international published literature associated with a particular topic and based on a research question. 

In this case, we analysed research into viral conditions which cause fatigue, such as SARS, MERS, Lyme disease and glandular fever. We looked at cases in people of all ages and ethnicities across the world. In order to focus on the most relevant research we decided to exclude from the study fatigue associated with fever, infection, sleep disturbances, pregnancy, extreme physical activity or depression, and autoimmune response following cancer and other neurological diseases.

We were interested in finding out about different interventions designed to help manage fatigue or conserve energy in research participants. These are often varied and non-pharmacological — for example, rest and exercise regimes often called ‘pacing’, psychological and behavioural change methods, and complementary medicine. Many interventions have been researched for their effectiveness but not all research is of the best quality and the systematic review aims to report critically on the combined learning from the studies.

To enable the research team to understand the ‘lived experience’ of fatigue and complete the study, we brought together an ‘expert group’ of people who have overcome fatigue or who work with people who are seeking to manage their illness.

We looked at many different interventions including • fatigue management • energy conservation • task adaptation • pacing methods • lifestyle management • work planning • technology-based interventions • light therapy • mindfulness • sleep advice • complementary medicine • primary care management • environmental adaptation and its impact • improving pacing through wearable devices such as heart rate monitors.  

Finally, we looked at the different ways people live — with and without carers living at home, their community, self-management, personal orientation, household or family, supported lifestyle management, work environments and health related work-planning.  

The outcome of our study will report on the quality of the research evidence and where possible ‘what works’ for different people (age groups and living situations) to reducing disruption to their everyday lives, at work and with leisure activities. Our work will be published and shared widely to enable learning and understanding about the best ways of supporting people with Long Covid via new products and services.

View the PROSPERO record